State agency tables pay cuts to independent private duty nurses

 

Tuesday, Nov 24,2009, 11:13:45 AM   Click:

The state Department of Health Services has tabled two proposed pay cuts to independent private duty nurses, who provide in-home care for severely disabled patients, many of whom rely on ventilators to breathe.

The move comes after a Wisconsin State Journal article about the cuts and complaints from patients, nurses and legislators, said Fran Meyer, president of Professional Homecare Providers, an association of the independent nurses.

About 2,200 of the nurses provide care in the homes of about 400 patients, often around the clock. Almost all of the patients are on Medicaid, the state-federal health plan for the poor.

State health officials planned to trim $4.9 million in pay to the nurses as part of $625 million in Medicaid cuts over two years. Patients said the cuts would make it harder to find in-home nurses and could force them to move to nursing homes.

About two-thirds of the nurses are registered nurses and a third are licensed practical nurses, who receive less training. The state pays the registered nurses $32.69 an hour and the licensed practical nurses $21.79 an hour. The nurses must pay Social Security taxes and cover health insurance, time off, travel and some supplies, which reduces their pay checks by well over a third, Meyer said.

According to a letter to legislators last week from Karen Timberlake, health department secretary, two proposed pay cuts have been dropped.

One proposal would have paid nurses 4 percent an hour more for up to eight hours a shift and 11 percent an hour less for additional hours. This was to discourage long shifts that can increase the risk of errors, state officials said. Meyer said 12-hour shifts are better for nurses and patients because fewer nurses are needed for each case.

The other proposal would have paid nurses 5 percent less for basic cases, a new designation for patients who need less care. State officials wouldn't say what types of patients or how many would be considered basic, but the reduction would have accounted for $3.5 million of the $4.9 million in total savings.

A third cut will remain, according to Timberlake's letter. A select group of nurses who make an additional $160 a month for scheduling nurse teams, ordering medications and otherwise coordinating a patient's care will lose the payment starting Jan. 1. The state doesn't give the payment to nurses at home health agencies, officials said.

Meyer said she is glad the cuts were dropped but is concerned about future cost-cutting measures. Timberlake's letter said the state still will "develop a more comprehensive care management strategy" for the nurses over the next two years.